Most people become approved for the Medicare eligibility age when they turn 65. However, there are a few exceptions. In this blog post, we will discuss disability and Medicare eligibility and enrollment in 2022. We will cover who is eligible for Medicare, when to enroll, and what happens if you don’t enroll on time. If you are approaching age 65 or have a loved one who is, be sure to read this post!

Enrolling in Medicare when you are on disability

It is a little different than enrolling when you turn 65? If you are under 65 and have been receiving Social Security Disability Insurance (SSDI) benefits for at least 24 months, you will be automatically enrolled in Medicare Part A and Part B. If you are not receiving SSDI benefits, you can still enroll in Medicare if you meet certain disability requirements.

To be eligible for Medicare, you must:

  • Be a U.S. citizen or permanent legal resident of at least five continuous years
  • Be age 65 or older, OR
  • Have a qualifying disability, OR
  • Have End-Stage Renal Disease (ESRD) or Lou Gehrig’s disease (ALS)

When your Medicare eligibility is approved, you can enroll in one of three ways: online, by phone, or in person. The easiest way to enroll is online. You can also call the Social Security Administration at 800-772-1213 to enroll over the phone. If you prefer to enroll in person, you can visit your local Social Security office.

When you enroll in Medicare, you will have to choose between Original Medicare (Part A and Part B) and a Medicare Advantage Plan (Part C). If you enroll in Original Medicare, you will also need to decide whether to sign up for Part D, which is prescription drug coverage. You can enroll in a stand-alone Part D plan even if you don’t have Original Medicare.

If you don’t enroll in Medicare when you are first eligible, you may have to pay a late enrollment penalty. The Part B late enrollment penalty is an extra ten percent of the premium for each full twelve-month period that you could have had Part B but didn’t sign up for it. There is no late enrollment penalty for Part A.

Do I have to take Part B to keep Disability with Medicare?

No, you don’t have to take Part B to keep your disability benefits. However, if you want to enroll in Part B, you must first sign up for Part A. You can sign up for Part A and Part B at the same time, or you can sign up for Part A first and then add Part B later.

If you are receiving SSDI benefits, you should enroll for Medicare eligibility three months before your 25th month of disability. If you wait to enroll, your Part B coverage will start the following month.

What if you get Medicare through Disability and then go back to work?

If you go back to work after getting approved for Medicare eligibility through disability, your coverage will not end as long as you continue to pay your Part B premium. However, if you stop paying your Part B premium, your coverage will be suspended. You can re-enroll in Part B by paying the premium retroactively for up to six months.

What Happens When Someone turns 65 and now qualifies for Medicare Eligibility?

If you are 65 or older, you have Medicare eligibility regardless of whether you are receiving Social Security benefits. You can enroll in Medicare three months before your 65th birthday, the month of your birthday, or three months after your 65th birthday. If you wait to enroll, your Part B coverage will start the following month.

Special Circumstance for Medicare Eligibility or Disability!

If you are receiving disability benefits from the Veterans Administration (VA), you do not need to enroll in Medicare. Your VA benefits will continue as long as you remain eligible. However, if you want to enroll in Medicare, you can do so without losing your VA benefits.

If you get diagnosed with any of the following illnesses ALS(Lou Gehrig’s Disease or ESRD (End-Stage Renal Disease).

Who is eligible for medicare? For ALS you will automatically get Medicare A and B the month your disability benefits begin

If you qualify for ESRD

  • For most people, Medicare Eligibility coverage will start on the 1st day of the 4th month of dialysis treatment.
  • If you have an employer group health plan, Medicare will begin on the fourth month of dialysis.
  • Treatments if you have employer coverage.
  • If you participate in an at-home dialysis training program, your coverage may begin the first month of a regular course of dialysis provided the following are true:
  • You participated in training from a Medicare-approved training facility for the first three months of your regular dialysis
  • Your doctor expects you to finish training and be able to do your dialysis treatments yourself

Note, according to Medicare to qualify with ESRD all of the below must apply:9

  •  Your kidneys no longer work
  • You need dialysis regularly or have had a kidney transplant
  • One of the following must be true for you:
  • You’re already eligible for or are currently getting Social Security or Railroad Retirement Board (RRB) benefits
  • You have worked the required amount of time under Social Security, the RRB, or as an employee of the government
  • You are either the spouse or dependent child of someone who meets either of the above requirements

If you need help with figuring out how to enroll in Medicare or the transitions for Disability let us help you.